Case-management of chronic disease : multiple sclerosis

The piece de resistance of Alize Timmerman's July seminar in Santa Fe was a case of M.S. with seven years of video follow-up from wheelchair to walking. (The patient had been in a wheelchair for 12 years before homeopathic treatment.) Using this case as a focal point, Alize skillfully wove in the threads of her understanding of long-term case-management, Herings Law, miasms, dreams as a means of understanding a case, remedies related on the periodic table of elements, and acute illness during chronic disease.
"Most cases of M.S. are stuck: blocked," says Alize. "They are one-sided diseases. Hahnemann discusses this in the Organon in paragraphs 173-179. In many of these cases there are no modalities. A case of M.S. without modalities is nearly incurable."
M.S. is a one-sided disease because you see only the function: the sensation has gone deep into the person and is completely gone. (Organon, paragraph 178) Many times we will not find the simillimum. In chronic disease, we don't give the right remedy only because we can't see it.
If a M.S. patient presents with intermittent blindness and vertigo, is the disease more or less advanced than if a patient presents with numbness in the legs? "If you think of Herings Law you can get confused," says Alize. "When it's numbness in the legs the disease has progressed much further. If the symptom is intermittent blindness or vertigo, its closer to the origin of the disease and it's a better sign."
With a remedy, if the M.S. patient returns to intermittent blindness, it's a very good sign. If a patient comes in with leg numbness right away and no blindness or if they don't remember it, its not a good sign. The patient will be very scared and patient education is important.
In anamnesis and case-management, there is often a forgotten history or story related to the paralysis. M.S. is a disease of paralysis and numbness on all levels: mental/emotional/physical. What the patient tells you is less important than her facial expressions.
In a normal chronic case, it's a good sign when the patient gets a fever. In a M.S. case, its a bad sign. And if the acutes are different from the chronic picture, this shows a "split-up" treatment. "Not that it is wrong; but we don't like to see the disease expressing itself on different levels in homeopathy," says Alize.
With M.S. , be a little more wary of aggravation. Aggravations are difficult with autoimmune diseases. So you must keep in close contact with these patients. As for potencies in the treatment of M.S. , with the LM potencies if the reaction is too much, you can give a higher LM and then you neutralize it a little bit more. With centessimal potencies you tend to see a little more action and reaction.
Although LM potencies can also catalyze strong reactions, they are usually gentle. If you don't see any reaction with LM potencies, you can go to a centessimal potency and then back to an LM. With M.S. cases, patients sometimes become worse and worse and you cannot see if the remedy is working. And even with amelioration, the patient may not feel the amelioration herself. In the best case scenario, the patient will still have M.S. , but not the symptoms.
There are several case-management possibilities with M.S. If nothing is getting better after two years, maybe the remedy can work in the periphery but not in the center -this is not a good sign. Sometimes a moment will come in a case when something comes up and you can see more to prescribe on. Another case-management scenario is that you will see remissions, yet the disease continues to get worse over time. Even in this case, patients generally are very happy with the treatment because M.S. is usually progressively debilitating. "Its a good sign if you see remissions," says Alize.
One treatment strategy Alize suggests includes alternating the specific and sensitive remedies. The sensitive remedy is meant to be a wide-range stimulus, aimed at raising the energy level and facilitating the surfacing of suppressed symptoms. The specific remedy is meant to spur healing of the underlying illness.
"The deeper the remedy works, the more the aggravation," says Alize. This is the reason some patients can't continue treatment. Always be open and look for the specific remedy. But sometimes you may give the sensitive remedy first because the patient isn't ready for the specific remedy yet.
The specific remedy is a deeper process and a painful process. Says Alize: "The patient must have the help of the remedy and the courage from you to go through this process."
Special thanks to Jim Klemmer who hosted the seminar. For more information on Santa Fe homeopathic seminars call Jim at 505-982-4071.
Christina Bautista, LM, is a licensed midwife and a 1993 graduate of the IFH Professional Course. She practices in Kalispell, and Missoula, Montana.